Abstract
Objective: Describe the rate of falls across different antiepileptic drugs (AEDs).
Background: According to Center for Disease Control, 30 million seniors fall each year-resulting in 30,000 deaths. Risk of falls is a burden to people with epilepsy (PWE) [1]. AEDs may cause dizziness, ataxia, peripheral neuropathy, and low bone density, leading to falls or further morbidity. Few studies have explored the relationship between specific AEDs and risk of falls [2,3].
Design/Methods: A retrospective analysis was conducted of PWE prescribed AEDs to capture reported falls and their causes. Consecutive charts of seizure clinic visits were reviewed as part of the Yale Antiepileptic Drug Database Project. Falls were then identified by patient report and corresponding physician documentation in the chart. We calculated number of falls per number of unique prescriptions per patient.
Results: 1344 PWE and 3411 prescriptions were included. The proportion of AED-attributed falls (and corresponding number of patients on the medications), listing per 1000 prescriptions, include: oxcarbazepine (n=305), 33 falls per 1000 prescriptions; clobazam (n=365), 27; eslicarbazepine (n=64), 15.6; carbamazepine (n= 568), 10.6; lamotrigine (n=651), 9.2; phenytoin (n=550), 9.1; phenobarbital (n=296), and 3.4; valproic acid (n=556), 3.6. Additionally, vagus nerve stimulation (n=56) was associated with 17.9 falls per 1000 surgeries. As a group, sodium channel blockers (n=2138) were associated with a larger proportion of falls (77 per 1000 prescriptions) compared to other treatments (n= 1273; 51.9 falls per 1000 prescriptions).
Conclusions: On univariate analysis, people with epilepsy treated with sodium channel blocking AEDs have a higher rate of falls in comparison to those treated with other treatments. We are currently in the process of extracting data to evaluate for confounders, perform multivariate analysis, review the cause of falls, and compare rates of injuries from falls including fractures
Disclosure: Dr. Hajjar has nothing to disclose. Dr. Jackson-Shaheed has nothing to disclose. Dr. Hirsch has received personal compensation for consulting, serving on a scientific advisory board, speaking, or other activities with Adamas, Aquestive, Ceribell, Eisai, Monteris, Marinus, Neuropace, and UCB.Dr. Altalib has nothing to disclose.
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